How much rates vary
Facilitymedian $2,818 · 10th to 90th $224 to $6,026Professionalmedian $427 · 10th to 90th $170 to $955
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $14,454.40 | Facility | None | $151.36 | $218.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $812.83 | Professional | None | $131.83 | $199.53 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $537.03 Typical High $1,096.48 | Professional | None | $199.53 | $537.03 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $512.86 Typical High $1,071.52 | Facility | None | $208.93 | $512.86 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $676.08 | Professional | None | $204.17 | $288.40 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $154.88 Median $2,630.27 Typical High $5,128.61 | Facility | None | $154.88 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $524.81 | Professional | None | $288.40 | $371.54 | $524.81 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $2,344.23 Typical High $4,786.30 | Facility | None | $275.42 | $2,344.23 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $1,000.00 | Professional | None | $169.82 | $416.87 | $1,000.00 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $562.34 | Professional | None | $257.04 | $346.74 | $562.34 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $186.21 Typical High $281.84 | Facility | None | $144.54 | $186.21 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $602.56 | Professional | None | $204.17 | $389.05 | $602.56 |
Quartz Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $1,479.11 | Facility | None | $208.93 | $316.23 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $389.05 | Professional | None | $204.17 | $288.40 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $724.44 Typical High $1,047.13 | Professional | None | $331.13 | $724.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $147.91 Median $389.05 Typical High $602.56 | Professional | None | $147.91 | $389.05 | $602.56 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $109.65 | Facility | 52 · Reduced service | $75.86 | $75.86 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $43.65 | Facility | 53 · Discontinued | $30.90 | $30.90 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $162.18 | Facility | 54 · Surgery only | $114.82 | $114.82 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $21.88 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $109.65 Typical High $426.58 | Professional | 52 · Reduced service | $75.86 | $109.65 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $169.82 | Professional | 53 · Discontinued | $30.90 | $43.65 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $645.65 | Professional | 54 · Surgery only | $114.82 | $162.18 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $128.82 | Professional | 55 · Aftercare only | $22.91 | $33.11 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $85.11 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $602.56 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 2nd of 51
$513
AK $550KY $141
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.